ArticleBMC health services research2003
Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers--a qualitative study.
Article in BMC health services research, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 129 citations in OpenAlex.
- Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework.Implementation science : IS · 2019Pooled it
- Lumbar Spine X-Ray as a Standard Investigation for all Low back Pain in Ghana: Is It Evidence Based?Ghana medical journal · 2017Pooled it
- Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review.BMC medical informatics and decision making · 2008Pooled it
- Improvement of primary care for patients with chronic heart failure: a study protocol for a cluster randomised trial comparing two strategies.Implementation science : IS · 2011Trial
- Exploring physicians' perspectives on influencing factors of chronic non-specific low back pain: a qualitative study.Scandinavian journal of primary health care · 2026Article
- Article
- User perspectives on systematic data collection regarding back pain managed in general practice - a qualitative study.BMC musculoskeletal disorders · 2022Article
- Determinants of clinical practice guidelines' utilization for the management of musculoskeletal disorders: a scoping review.BMC musculoskeletal disorders · 2021Article
- Are Emergency Medicine Provider Characteristics Associated With Diagnostic Imaging for Low Back Pain?Cureus · 2021Article
- Barriers and facilitators to reduce low-value care: a qualitative evidence synthesis.BMJ open · 2020Article
- Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis.BMJ open · 2020Article
- Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors.Chiropractic & manual therapies · 2019Article
- Using behaviour change theory and preliminary testing to develop an implementation intervention to reduce imaging for low back pain.BMC health services research · 2018Article
- Barriers and facilitators for guideline adherence in diagnostic imaging: an explorative study of GPs' and radiologists' perspectives.BMC health services research · 2018Article
- Meta-ethnography to understand healthcare professionals' experience of treating adults with chronic non-malignant pain.BMJ open · 2017Article
- Attitudes and diagnostic practice in low back pain: A qualitative study amongst Greek and British physiotherapists.World journal of orthopedics · 2016Article
- Do "Myths" of low back pain exist among Irish population? A cross-sectional study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2016Article
- Low Back Imaging When Not Indicated: A Descriptive Cross-System Analysis.The Permanente journal · 2016Article
- Healthcare provider and patient perspectives on diagnostic imaging investigations.African journal of primary health care & family medicine · 2015Article
- Adherence of doctors to a clinical guideline for hypertension in Bojanala district, North-West Province, South Africa.African journal of primary health care & family medicine · 2015Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneral practitioners often diverge from clinical guidelines regarding spine radiography. This study aimed to identify and describe A) factors general practitioners consider may affect their decisions about ordering plain radiography for back pain and B) barriers to guideline adherence suggested by such factors.
methodsFocus group interviews regarding factors affecting ordering decisions were carried out on a diverse sample of Norwegian general practitioners and were analysed qualitatively. Results of this study and two qualitative studies from the Netherlands and USA on use of spine radiography were interpreted for barriers to guideline adherence. These were compared with an existing barrier classification system described by Dr Cabana's group.
resultsThe factors which Norwegian general practitioners considered might affect their decisions about ordering plain radiography for back pain concerned the following broader issues: clinical ordering criteria, patients' wishes for radiography and the general practitioner's response, uncertainty, professional dignity, access to radiology services, perception of whether the patient really was ill, sense of pressure from other health care providers/social security, and expectations about the consequences of ordering radiography. The three studies suggested several attitude-related and external barriers as classified in a previously reported system described by Dr Cabana in another study. Identified barriers not listed in this system were: lack of expectancy that guideline adherence will lead to desired health care process, emotional difficulty with adherence, improper access to actual/alternative health care services, and pressure from health care providers/organisations.
conclusionsOur findings may help implement spine radiography guidelines. They also indicate that Cabana et al.'s barrier classification system needs extending. A revised system is proposed.
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